|
|
| (41 intermediate revisions by 5 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| | {{Spina bifida}} |
| | {{CMG}}; {{AE}}, {{MMJ}}, {{M.B}} |
| | ==[[Spina bifida overview|Overview]]== |
|
| |
|
| {{CMG}}{{AE}}{{MMJ}}
| | ==[[Spina bifida historical perspective|Historical Perspective]]== |
| ==Classification== | |
| *Spina bifida may be classified according to the level of the lesion into 3 subtypes:<ref name="pmid2782071">{{cite journal |vauthors=Lannering B, Albertsson-Wikland K |title=Improved growth response to GH treatment in irradiated children |journal=Acta Paediatr Scand |volume=78 |issue=4 |pages=562–7 |date=July 1989 |pmid=2782071 |doi= |url=}}</ref><ref name="pmid7814582">{{cite journal |vauthors=Swank M, Dias LS |title=Walking ability in spina bifida patients: a model for predicting future ambulatory status based on sitting balance and motor level |journal=J Pediatr Orthop |volume=14 |issue=6 |pages=715–8 |date=1994 |pmid=7814582 |doi= |url=}}</ref>
| |
| :#[[Thoracic]], high-[[lumbar]]
| |
| :#*Lack of [[Quadriceps muscle|quadriceps]] function
| |
| :#Low-[[lumbar]]
| |
| :#*Lack [[Gluteus medius muscle|gluteus medius]] and [[Gluteus maximus muscle|maximus]] function
| |
| :#*Retain [[Quadriceps muscle|quadriceps]] and [[Hamstrings|medial hamstring]] function
| |
| :#[[Sacral]]
| |
| :#*Lack [[Gastrocnemius muscle|gastrocnemius-]][[Soleus muscle|soleus]] function in high [[sacral]] lesions
| |
| :#*Retain [[Gastrocnemius muscle|gastrocnemius]]-[[soleus]] function in low [[Sacrum|sacral]] lesions
| |
| :* Spina bifida also may be classified according to the tyoe of the vertebrate defect into 2 subtypes:<ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref><ref name="pmid4898641">{{cite journal |vauthors=Bannur BB, Purandare GM |title=Microbial production of L-lysine |journal=Hindustan Antibiot Bull |volume=11 |issue=3 |pages=191–205 |date=February 1969 |pmid=4898641 |doi= |url=}}</ref>
| |
| :*# [[Spina bifida occulta]]: In this type of spina bifida, the defect of [[vertebrate]] is covered by [[skin]] ("Occulta" means "hidden"). The [[spinal cord]] does not stick out through the skin, although the skin over the lower spine may have a patch of hair, a [[birthmark]], or a dimple above the groove between the [[buttocks]].
| |
| :*# Spina ifida aperta: In this type of spina bifida , the defect is widely open and is sub classified into 2 types: Meningocele and Myelomeningocele.
| |
|
| |
|
| :* Meningocele is a protrusion of the meninges, unaccompanied by neural tissue, through a bony defect in the [[vertebral column]].
| | ==[[Spina bifida classification|Classification]]== |
| :* Myelomeningocele is the most severe form of spina bifida. It happens when both the meninges and the bottom end of the spinal cord push through the hole in the spine, forming a large fluid-filled sac that bulges out of a patients back.
| |
|
| |
|
| ==Pathophysiology== | | ==[[Spina bifida pathophysiology|Pathophysiology]]== |
| * Spina bifida is a congenital malformation in which the spinal column is split (bifid) as a result of failed closure of the embryonic neural tube, during the fourth week post-fertilization.<ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref>
| |
| * [[Spina bifida occulta]]: In this type of spina bifida, the defect of [[vertebrate]] is covered by [[skin]] ("Occulta" means "hidden"). The [[spinal cord]] does not stick out through the skin, although the skin over the lower spine may have a patch of hair, a [[birthmark]], or a dimple above the groove between the [[buttocks]].<ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref>
| |
| * Spina ifida aperta: In this type of spina bifida , the defect is widely open and is sub classified into 2 types: Meningocele and Myelomeningocele.<ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref>
| |
| ==Differentiating spina bifida from other Diseases==
| |
| *Spina bifida must be differentiated from other diseases that cause [[vertebral column]] defects, such as:
| |
| :*Terminal myelocystocele<ref name="pmid9514174">{{cite journal |vauthors=Meyer SH, Morris GF, Pretorius DH, James HE |title=Terminal myelocystocele: important differential diagnosis in the prenatal assessment of spina bifida |journal=J Ultrasound Med |volume=17 |issue=3 |pages=193–7 |date=March 1998 |pmid=9514174 |doi= |url=}}</ref>
| |
| :*Spine segmental [[dysgenesis]]<ref name="pmid3374785">{{cite journal |vauthors=Scott RM, Wolpert SM, Bartoshesky LE, Zimbler S, Karlin L |title=Segmental spinal dysgenesis |journal=Neurosurgery |volume=22 |issue=4 |pages=739–44 |date=April 1988 |pmid=3374785 |doi= |url=}}</ref>
| |
| :*[[Caudal regression syndrome]] ([[sacral agenesis]])<ref name="pmid4925436">{{cite journal |vauthors=Kremser E, Mitchell GM |title=Treatment of primary dysmenorrhea with a combined type oral contraceptive--a double blind study |journal=J Am Coll Health Assoc |volume=19 |issue=3 |pages=195–6 |date=February 1971 |pmid=4925436 |doi= |url=}}</ref>
| |
| :*Multiple [[vertebral]] segmentation disorder<ref name="pmid5991006">{{cite journal |vauthors=Benedetti-Valentino F J, De Feo V, Pistolese GR, Fiorani P |title=[Nephroptosis and fibromuscular hyperplasia of the tunica media of the renal arteries] |language=Italian |journal=Minerva Cardioangiol |volume=14 |issue=9 |pages=528–34 |date=September 1966 |pmid=5991006 |doi= |url=}}</ref>
| |
| :*[[VACTERL]]<ref name="pmid3169446">{{cite journal |vauthors=Naccarato R, Sturniolo GC, Martin A, D'Odorico A, Montino C |title=[Irritable bowel syndrome] |language=Italian |journal=G Clin Med |volume=69 |issue=3 |pages=163–8 |date=March 1988 |pmid=3169446 |doi= |url=}}</ref>
| |
|
| |
|
| ==Epidemiology and Demographics== | | ==[[Spina bifida causes|Causes]]== |
| * The prevalence of spina bifida is approximately 187 to 890 per 100,000 live births depending on weightage.
| |
|
| |
| ===Age===
| |
| *Spina bifida is more commonly observed among preterm newborns.
| |
| *[Disease name] is more commonly observed among [elderly patients/young patients/children].
| |
|
| |
| ===Gender===
| |
| *[Disease name] affects men and women equally.
| |
|
| |
| *[Gender 1] are more commonly affected with [disease name] than [gender 2].
| |
| * The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
| |
|
| |
| ===Race===
| |
| *There is no racial predilection for [disease name].
| |
|
| |
| *[Disease name] usually affects individuals of the [race 1] race.
| |
| *[Race 2] individuals are less likely to develop [disease name].
| |
|
| |
| ==Risk Factors==
| |
| *Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
| |
|
| |
| == Natural History, Complications and Prognosis==
| |
| *The majority of patients with [disease name] remain asymptomatic for [duration/years].
| |
| *Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
| |
| *If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
| |
| *Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
| |
| *Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
| |
|
| |
|
| == Diagnosis == | | ==[[Spina bifida differential diagnosis|Differentiating Spina bifida from other Diseases]]== |
| ===Diagnostic Criteria===
| |
| *The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
| |
| :*[criterion 1]
| |
| :*[criterion 2]
| |
| :*[criterion 3]
| |
| :*[criterion 4]
| |
|
| |
| === Symptoms ===
| |
| *[Disease name] is usually asymptomatic.
| |
| *Symptoms of [disease name] may include the following:
| |
| :*[symptom 1]
| |
| :*[symptom 2]
| |
| :*[symptom 3]
| |
| :*[symptom 4]
| |
| :*[symptom 5]
| |
| :*[symptom 6]
| |
|
| |
| === Physical Examination ===
| |
| *Patients with [disease name] usually appear [general appearance].
| |
| *Physical examination may be remarkable for:
| |
| :*[finding 1]
| |
| :*[finding 2]
| |
| :*[finding 3]
| |
| :*[finding 4]
| |
| :*[finding 5]
| |
| :*[finding 6]
| |
|
| |
|
| === Laboratory Findings === | | ==[[Spina bifida epidemiology and demographics|Epidemiology and Demographics]]== |
| *There are no specific laboratory findings associated with [disease name].
| |
|
| |
|
| *A [positive/negative] [test name] is diagnostic of [disease name].
| | ==[[Spina bifida risk factors|Risk Factors]]== |
| *An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
| |
| *Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
| |
|
| |
| ===Imaging Findings===
| |
| *There are no [imaging study] findings associated with [disease name].
| |
|
| |
| *[Imaging study 1] is the imaging modality of choice for [disease name].
| |
| *On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
| |
| *[Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
| |
|
| |
| === Other Diagnostic Studies ===
| |
| *[Disease name] may also be diagnosed using [diagnostic study name].
| |
| *Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
| |
|
| |
| == Treatment ==
| |
| === Medical Therapy ===
| |
| *There is no treatment for [disease name]; the mainstay of therapy is supportive care.
| |
|
| |
| *The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
| |
| *[Medical therapy 1] acts by [mechanism of action 1].
| |
| *Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
| |
|
| |
| === Surgery ===
| |
| *Surgery is the mainstay of therapy for [disease name].
| |
| *[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
| |
| *[Surgical procedure] can only be performed for patients with [disease stage] [disease name].
| |
|
| |
| === Prevention ===
| |
| *There are no primary preventive measures available for [disease name].
| |
|
| |
| *Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
| |
|
| |
|
| *Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
| | ==[[Spina bifida screening|Screening]]== |
| ==References==
| |
| {{Reflist|2}}
| |
|
| |
| [[Category:Pick One of 28 Approved]]
| |
|
| |
|
| {{WS}}
| | ==[[Spina bifida natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| {{WH}}
| | |
| | ==Diagnosis== |
| | [[Spina bifida diagnostic study of choice|Diagnostic study of choice]] | [[Spina bifida history and symptoms|History and Symptoms]] | [[Spina bifida physical examination|Physical Examination]] | [[Spina bifida laboratory findings|Laboratory Findings]] | [[Spina bifida electroencephalogram|Electroencephalogram]] | [[Spina bifida x ray|X-Ray Findings]] | [[Spina bifida echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Spina bifida CT scan|CT-Scan Findings]] | [[Spina bifida MRI|MRI Findings]] | [[Spina bifida other imaging findings|Other Imaging Findings]] | [[Spina bifida other diagnostic studies|Other Diagnostic Studies]] |
| | |
| | ==Treatment== |
| | [[Spina bifida medical therapy|Medical Therapy]] | [[Spina bifida surgery|Surgery]] | [[Spina bifida primary prevention|Primary Prevention]] |
| | |
| | ==Case Studies== |
| | [[Spina bifida case study one|Case #1]] |
| | |
| | [[Category: (name of the system)]] |